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Journal of Neurology

, Volume 261, Issue 12, pp 2275–2282 | Cite as

Costeff syndrome: clinical features and natural history

  • Gilad Yahalom
  • Yair Anikster
  • Ruth Huna-Baron
  • Chen Hoffmann
  • Lubov Blumkin
  • Dorit Lev
  • Rakefet Tsabari
  • Zeev Nitsan
  • Sheera F. Lerman
  • Bruria Ben-Zeev
  • Ben Pode-Shakked
  • Shira Sofer
  • Avraham Schweiger
  • Tally Lerman-Sagie
  • Sharon Hassin-Baer
Original Communication

Abstract

Costeff syndrome (CS) is a rare autosomal-recessive neurological disorder, which is known almost exclusively in patients of Iraqi Jewish descent, manifesting in childhood with optic atrophy, ataxia, chorea and spastic paraparesis. Our aim was to study the clinical spectrum of CS and natural history using a cross-sectional study design. Consecutive patients with CS were recruited to the study. Patients were diagnosed based on clinical features, along with elevated urinary levels of methylglutaconic and methylglutaric acid, and by identification of the disease-causing mutation in the OPA3 gene in most. All patients were examined by a neurologist and signs and symptoms were rated. 28 patients with CS (16 males, 21 families, age at last observation 28.6 ± 16.1 years, range 0.5–68 years) were included. First signs of neurological deficit appeared in infancy or early childhood, with delayed motor milestones, choreiform movements, ataxia and visual disturbances. Ataxia and chorea were the dominant motor features in childhood, but varied in severity among patients and did not seem to worsen with age. Pyramidal dysfunction appeared later and progressed with age (r = 0.71, p < 0.001) leading to spastic paraparesis and marked gait impairment. The course of neurological deterioration was slow and the majority of patients could still walk beyond the fifth decade. While visual acuity seemed to deteriorate, it did not correlate with age. CS is a rare neurogenetic disorder that causes serious disability and worsens with age. Spasticity significantly increases over the years and is the most crucial determinant of neurological dysfunction.

Keywords

Costeff Methylglutaconic aciduria Natural course OPA3 

Notes

Acknowledgments

The authors are deeply in debt to the patients and families for their participation.

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standard

This study was carried in accordance with ethical standards as set out in the Declaration of Helsinki.

Supplementary material

415_2014_7481_MOESM1_ESM.tif (6.8 mb)
Supplemental Figure A: Additional 11 pedigrees of families with CS. Detailed are the pedigrees of families H, J, S, N, M, O, F, K, P, A and R. Full signs designate affected individuals, index patients are designated with arrows. Of note, several families exhibit additional Costeff-suspected patients who were not included in the study cohort. Consanguinity can be noted in families S and O. (TIFF 6998 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Gilad Yahalom
    • 1
    • 2
    • 9
  • Yair Anikster
    • 3
    • 9
  • Ruth Huna-Baron
    • 5
    • 9
  • Chen Hoffmann
    • 6
    • 9
  • Lubov Blumkin
    • 7
    • 9
  • Dorit Lev
    • 8
    • 9
  • Rakefet Tsabari
    • 2
  • Zeev Nitsan
    • 1
    • 2
  • Sheera F. Lerman
    • 1
    • 2
    • 11
  • Bruria Ben-Zeev
    • 4
    • 9
  • Ben Pode-Shakked
    • 3
  • Shira Sofer
    • 10
  • Avraham Schweiger
    • 10
  • Tally Lerman-Sagie
    • 7
    • 9
  • Sharon Hassin-Baer
    • 1
    • 2
    • 9
  1. 1.Parkinson Disease and Movement Disorders ClinicChaim Sheba Medical CenterTel-HashomerIsrael
  2. 2.Department of Neurology, Sagol Neuroscience CenterChaim Sheba Medical CenterTel-HashomerIsrael
  3. 3.Metabolic Disease UnitEdmond and Lily Safra Children’s Hospital, Chaim Sheba Medical CenterTel-HashomerIsrael
  4. 4.Pediatric Neurology UnitEdmond and Lily Safra Children’s Hospital, Chaim Sheba Medical CenterTel-HashomerIsrael
  5. 5.Goldschleger Eye InstituteChaim Sheba Medical CenterTel-HashomerIsrael
  6. 6.Radiology DepartmentChaim Sheba Medical CenterTel-HashomerIsrael
  7. 7.Pediatric Neurology UnitWolfson Medical CenterHolonIsrael
  8. 8.Institute of Medical GeneticsWolfson Medical CenterHolonIsrael
  9. 9.Sackler Faculty of MedicineTel-Aviv UniversityTel-AvivIsrael
  10. 10.Faculty of PsychologyAcademic College of Tel-Aviv-JaffaTel-AvivIsrael
  11. 11.Department of PsychologyBen Gurion University of the NegevBeer ShevaIsrael

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